The presence of Listeria was investigated in ripened cheeses (Chihuahua, Manchego) and fresh cheese (Panela) from street vendors and retail stores in Mexico City. Cheeses were tested for Listeria, pH, NaCl, moisture and fat. Listeria selective cold enrichment was used to recover Listeria from positive samples. Fresh cheese had the lowest pH and NaCl contents and the highest moisture Chihuahua and Manchego cheeses made with pasteurized milk were negative for Listeria. Panela cheese samples were the most contaminated. The presence of Listeria was 65% in fresh cheeses: Listeria murrayi 20%, Listeria inoccua 15%, Listeria grayi 15%, and Listeria monocytogenes 15%. L. monocytogenes serotypes 1/2a, 1/2b and 4b were isolated from positive samples.

To investigate whether cortisol secretory patterns are associated with a response to cyproheptadine treatment in Cushing's disease, we studied two patients with a hyperpulsatile pattern and one patient with a hypopulsatile pattern before and during chronic cyproheptadine therapy (24 mg daily). In the two patients with a hyperpulsatile cortisol secretory pattern, pituitary magnetic resonance imaging with gadolinium did not reveal a pituitary adenoma, whereas in the patient with a hypopulsatile cortisol secretory pattern, a microadenoma was identified. Plasma cortisol levels were measured every 30 min for 24 h. In the two patients with a hyperpulsatile cortisol secretory pattern, chronic treatment with cyproheptadine resulted in sustained clinical and biochemical improvement and normalization of the median of absolute and relative increments in cortisol spikes. In the patient with a hypopulsatile cortisol secretory pattern, only a reduction of cortisol spikes was noticed during treatment. These results suggest that patients with Cushing's disease who are characterized by a hyperpulsatile cortisol secretory pattern and in whom no pituitary lesion can be identified by magnetic resonance imaging, cyproheptadine treatment may be useful.

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